| NPI | 1639438732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDAL SCOTT PUHN Dentist 360-779-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA 603194747) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2013-06-04 |